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Sampled

=esantionat

Mean value

=valoare medie

Threshold

=prag

square root

=radacina patrata

appropriate

=corespunzator

delayed

=intarziat

lowest highest =cel mai mic/mare


artefacts
= artefacte sau semnale
parazite/zgomot
noisy

=zgomot sau semnal perturbat

counts

=numere

closely

=apropiat

watches

= asemanator

lumped parameters =Parametri concentrati


increase

= creste

shorter

=scurteaza

pie chart

=graficul proportiilor

Introducere: Granulomul facial este o


afectiune rar, caracterizat clinic prin una
sau mai multe plci sau noduli, bine
delimitate, de coloraie roie-violacee sau
brun, localizate ndeosebi la nivelul feei
dar i extrafacial. O serie de aspecte
histologice precum prezena eozinofilelor
faciliteaz diagnosticul de granulom facial.
Caz clinic: Pacient n vrst de 59 ani este
consultat pentru prezena a dou plci de
coloraie roie-brun, bine delimitate, cu
suprafaa mamelonat, cu dimensiuni de
2,5 cm i respectiv 1,5 cm, asimptomatice,
localizate la nivelul feei. Histopatologic
la nivelul dermului mijlociu i profund este
prezent un infiltrat inflamator polimorf
localizat ndeosebi perivascular i format
din polinucleare neutrofile i eozinofile,
histiocite, limfocite, plasmocite. Infiltratul
celular respect epidermul i anexele
pilosebacee, iar capilarele sunt afectate.
Examenul clinic i histopatologic au
stabilit diagnosticul de granulom facial.
Tratamentul a constat n injecii
intralezionale cu betametazon urmate de
aplicaii de unguent cu tacrolimus 0,1% cu
dispariia aproape complet a leziunilor.
Discuii: Etiopatogenia granulomului
facial rmne neclar cu implicarea
expunerilor la soare sau considerarea
acestuia ca o form de vasculit mediat
de complexe imune generate de un rspuns
de tipul fenomenului Arthus localizat. n
privina tratamentului nu exist medicaii
eficace i specifice, fiind ncercate o serie
de tratamente medicale i chirurgicale.
Concluzie: Localizarea granulomului
facial la nivelul feei precum i evoluia
cronic, recidivant dup diverse terapii
constituie adesea o problem terapeutic.
Cuvinte cheie: granulom, eosinofile,
tacrolimus.

Introduction: Granuloma faciale is an


uncommon dermatosis characterized by
single or multiple sharply demarcated,
asymptomatic, red-purple or brown
plaques or nodules, usually occurring over
the face, but occasionally extrafacial
involvement was noted. Some histological
characteristics as presence of eosinophil
granulocytes facilitate the diagnosis of
granuloma faciale. Clinical case: A 59year-old male patient presented with two
well demarcated, asymptomatic, reddishbrown plaques, with a smooth surface with
prominent follicular orifices, 2,5 cm and
respectively 1,5 cm in diameter, on his
face. Histopathological examination
showed polymorphous inflammatory
infiltrate located in the papillary and
reticular dermis comprising of neutrophils,
eosinophils, hystiocytes, lymphocytes and
plasmocytes, predominantly with
perivascular pattern, sparing the epidermis
and periappendageal areas, but the
capillaries were affected. Clinical and
histopathological examinations have been
sustained diagnosis of granuloma faciale.
The patient was treated with intralesional
betamethasone followed by almost
complete resolution of lesions. Discussion:
The etiology of granuloma faciale remains
unknown. It has been suggested that
actinic exposure may play an important
role or this may be a form of vasculitis
mediated by circulating immune
complexes due to a localized Arthus-like
response. There are not an efficient and
specific medication of granuloma faciale,
therefore, many different medical ans
surgical therapies have been tried.
Conclusion: Location on the face and
chronic relapsing course after various
therapies make granuloma faciale a
problem of treatment. Key words:
granuloma, eosinophils, tacrolimus.

Rezumat: Orice bolnav de inim se confrunt cu un risc crescut de fibrilatie atrial. De


asemenea, oamenii cu probleme tiroidiene, diabet i hipertensiune arterial au un risc
crescut pentru apariia acestei boli. Cu ct naintm n vrst, cu att este mai mare
riscul de apariie a fibrilaiei atriale. Fibrilaia atrial poate determina apariia unor
complicaii destul de severe i de asemenea duce la afectarea calitii vieii pacienilor.
Una din ntrebrile care se pun n ultima perioad i a crui rspuns nu este pe deplin
elucidat este dac ablaia prin cateter reprezint cea mai bun terapie antiaritmic n
fibrilaia atrial. Unele descoperiri argumenteaz utilizarea ablaiei cu cateter n
tratamentul fibrilaiei atriale paroxistice care nu rspunde la prima ncercare de conversie
medicamentoas la ritm sinusal. Date obinute din studii publicate par s confirme sau
mai degrab s ntreasc ideea c succesul obinut pe o perioad de urmrire a
pacientului de 12 luni, nu garanteaz n mod automat succesul permanent, iar sperana
actual c ablaia n fibrilaia atrial este o procedur curativ continu s fie nruit de
realitatea c aceast boal recidiveaz dup o anumit perioad de timp. Astfel, ablaia
ca tratament a fibrilaiei atriale pare s aibe un efect mai degrab paleativ dect un efect
curativ, cel puin la majoritatea pacienilor.
Abstract: Any sick heart faces an increased risk of atrial fibrillation. Also, people with
thyroid problems, diabetes and hypertension are at increased risk for developing this
disease. With the older patients, the risk of atrial fibrillation is higher. Atrial fibrillation
may result in flat complications, severe enough and also may lead to impaired quality of
patients life. One of the questions posed in the last period and whose response is not fully
elucidated is whether catheter ablation is the best antiarrhythmic therapy in atrial
fibrillation. Some findings argue for the early use of catheter ablation therapy in the
patients with paroxysmal atrial fibrillation unresponsive to the initial attempts with
pharmacologic control. Data from the published studies seem to confirm that success over
a 12 month-follow up does not necessarily guarantee permanent success and that the early
hope of atrial fibrillation ablation is a curative procedure continues to be shattered by the
harsh reality that atrial fibrillation does in fact reoccur after several months. Thus, atrial
fibrillation seems to have a palliative rather than curative effect at least in most of the
patients